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肘部手术入路的综合综述。

Comprehensive review of surgical approaches to the elbow.

作者信息

Aggarwal Saurabh, Paknikar Kiran, Sinha Joydeep, Compson Jonathan, Reichert Ines

机构信息

Princess Royal University Hospital, Kings College Hospital, NHS Foundation Trust, Farnborough Common, Orpington, BR6 8ND, UK.

Kings College Hospital NHS Foundation Trust, Denmark Hill, Brixton, London, SE5 9RS, UK.

出版信息

J Clin Orthop Trauma. 2021 Jun 21;20:101482. doi: 10.1016/j.jcot.2021.101482. eCollection 2021 Sep.

Abstract

The choice of the most suitable surgical approach to the elbow forms the foundation of any successful elbow surgery. The surgical approach is based on the injury or pathology to be addressed and therefore specific anatomical details need to be considered. The surgeon must be comfortable with the bony, ligamentous and neurovascular anatomy of the elbow to consider and execute the best approach for each problem. This is an imperative to avoid iatrogenic injury. This article provides a detailed analysis, valuable technical tips, advantages and disadvantages of the most common approaches to the elbow. The lateral approaches include the Kocher, Kaplan and Extensor Digitorum Communis (EDC) Split approaches, the medial approaches include the Hotchkiss, Flexor carpi ulnaris (FCU) splitting approach, the Taylor and Scham approach. The anterior approach includes the anterior neurovascular interval approach and the posterior approaches include the Olecranon osteotomy, triceps sparing, triceps reflecting approach and finally the Boyd interval approach. The text and illustrations will provide a structured overview for the practicing surgeon.

摘要

选择最适合肘部的手术入路是任何成功的肘部手术的基础。手术入路基于要处理的损伤或病理情况,因此需要考虑特定的解剖细节。外科医生必须熟悉肘部的骨骼、韧带和神经血管解剖结构,以便为每个问题考虑并实施最佳入路。这是避免医源性损伤的必要条件。本文详细分析了肘部最常见入路的宝贵技术要点、优缺点。外侧入路包括科赫尔(Kocher)、卡普兰(Kaplan)和指总伸肌(EDC)劈开入路;内侧入路包括霍奇基斯(Hotchkiss)、尺侧腕屈肌(FCU)劈开入路、泰勒(Taylor)和沙姆(Scham)入路;前侧入路包括前神经血管间隙入路;后侧入路包括鹰嘴截骨术、保留肱三头肌、肱三头肌翻转入路,最后是博伊德(Boyd)间隙入路。本文的文字和插图将为执业外科医生提供结构化的概述。

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